Hypermobility In Children

I’ll never forget a little boy I saw from Brighton — let’s call him Max. His mum brought him in after his third ankle sprain in one term. She said he was “just clumsy” and always falling over. But when I asked a few more questions, a pattern started to emerge: knees that bent a little too far backwards, feet that flattened like pancakes when he stood, and joints that popped or clicked without pain.

What she thought was a rough patch of growing pains turned out to be something I see a lot in the clinic — hypermobility.

Now, let’s be clear: kids should be flexible. Their bones are still developing and their soft tissues are naturally more elastic. But there’s a tipping point. If that flexibility doesn’t start to settle down by around age 10 — or if it’s paired with constant falls, muscle fatigue or odd pains at night — it may not be “normal” flexibility at all.

At Well Heeled Podiatry, we see this often in kids who are otherwise active and healthy — especially those who play sports like Auskick, netball, or do gymnastics and ballet. Many of them have been called “double-jointed” or just “bendy.” But behind that bendiness can be a real issue with joint stability that affects everything from their gait to their confidence on the playground.

As a mum and podiatrist, I know how easy it is to brush these signs off. But left unchecked, hypermobility can set kids up for long-term pain and injury.

The good news? We can do something about it — and early support can make a massive difference.

What is hypermobility, really?

You’ve probably heard the phrase “double-jointed” tossed around at school or sport. It sounds harmless — even kind of impressive. But in clinic, when I assess kids with ongoing sprains or foot pain, that bendy flexibility often tells a deeper story.

Hypermobility means a child’s joints move beyond the normal range. It’s not just about being “really stretchy” — it’s about whether that flexibility is causing the body to work harder than it should just to stay upright and stable.

We use a simple tool called the Beighton Score to help assess this. It’s a 9-point scale that looks at how far certain joints can move. Here’s a rough guide parents can try at home (gently, please!):

Movement	Check both sides	Point(s)
Can they bend their pinky fingers back beyond 90 degrees?	Yes = 1 per hand	2
Can they pull their thumbs to touch their forearm?	Yes = 1 per thumb	2
Can their elbows straighten past straight?	Yes = 1 per elbow	2
Do their knees hyperextend backwards?	Yes = 1 per knee	2
Can they touch the floor with palms flat, knees straight?	Yes = 1	1
Total Possible Points		9

A score of 4 or more may suggest generalised hypermobility, especially if paired with other symptoms like joint pain or poor coordination.

So what’s going on in the body?

It all comes down to collagen, the protein that gives strength and structure to our joints, tendons, and ligaments. In kids with hypermobility, the collagen is a bit “looser.” Imagine trying to hold a tent upright with elastic ropes instead of strong ones — things start to wobble, and you need a lot more effort just to stay steady.

That means everyday movements — running, jumping, even just standing in the schoolyard — can become tiring or painful.

And it’s not just about the feet or ankles. Hypermobility can affect multiple joints, but it often shows up in the lower limbs first, especially if a child has flat feet or is growing quickly.

Signs your child’s joints are too loose

Some signs of hypermobility are loud and obvious — like a child who rolls their ankle every few weeks or can’t keep up with their peers in sport. Others are much quieter, like a kid who just doesn’t sleep well because their legs ache at night. Either way, the signs are worth paying attention to.

Here’s what I often see in the clinic — and what parents have told me they notice at home:

Common signs of hypermobility in children

• Joint pain or swelling — especially around the knees, ankles, elbows, and wrists. Often worse after activity or in the evening.
• “Growing pains” at night — that aching feeling in the calves or thighs that wakes them up or stops them settling.
• Frequent trips and falls — more than you’d expect for their age. Sometimes it looks like they’re just a “klutz,” but there’s often a stability issue underneath.
• Poor coordination or fatigue — these kids may avoid running games or tire quickly in PE.
• Flat feet — or feet that roll in heavily (pronation), which often goes hand-in-hand with joint laxity.
• Ankle sprains and soft tissue injuries — especially in active kids playing sport or doing dance.
• Loose skin or bruising easily — in some rarer cases.
• Clicky joints or dislocations — in more severe presentations.

You might also notice things like:

• Sitting in a “W” position (legs splayed behind them) for long periods
• Slouching or struggling to sit upright for more than a few minutes
• Cramping in the calves after a day at school or sport

Why these signs matter

Here’s the thing: kids with hypermobility often have to work twice as hard to do what comes naturally to others. Their muscles are constantly trying to stabilise joints that don’t have a strong foundation. It’s tiring, it can knock their confidence, and over time, it can lead to chronic pain or injury.

Quick comparison: Flexible vs. hypermobile

Normal Flexibility	Hypermobility Concern
Can do the splits but no pain or instability	Always tripping or rolling ankles
Flexible fingers but normal strength	Hands tire quickly when writing
W-sits occasionally	W-sits constantly + poor core strength
Outgrows flexibility by age 10	Still overly bendy well into tweens/teens
No pain after play	Night pain, fatigue, or muscle cramps

What causes hypermobility in kids?

Parents often ask, “Did we do something wrong?” when they hear their child is hypermobile. Let me reassure you — hypermobility isn’t something you cause, and in many cases, it runs in the family.

If you or your partner were the “bendy one” growing up — the kid who could flip into a backbend or fold in half on the school mat — there’s a fair chance your child has inherited some of that flexibility too.

Genetics: It tends to run in families

Hypermobility is often a genetic trait, meaning your child may have inherited their joint flexibility from a parent or grandparent. Sometimes it shows up as mild — a bit of extra movement but no symptoms. Other times, it can have a bigger impact.

I often ask parents during assessments: “Were you very flexible as a child? Could you do party tricks with your joints?” The look of recognition says it all.

Connective tissue conditions

In some cases, hypermobility is part of a connective tissue syndrome — a group of conditions that affect collagen and how the body builds support structures. These include:

• Ehlers-Danlos Syndrome (EDS) – A condition where the body produces collagen that’s too stretchy or fragile. It can affect skin, joints, and blood vessels.
• Marfan Syndrome – A genetic condition that affects connective tissue and often involves very long limbs and fingers.
• Down Syndrome – Children with Down Syndrome often have generalised ligament laxity, making their joints more mobile than average.

These syndromes are rare, and not all hypermobile kids have them. But if we suspect a broader issue based on their history, I’ll often collaborate with your child’s GP or paediatrician for further evaluation.

Growth and development

Many kids go through a naturally bendy phase, especially between the ages of 3 and 10. Their muscles and bones are growing at different rates, and their ligaments haven’t fully toughened up yet.

But if that “looseness” lingers past the age of 10, or if it starts causing pain, weakness, or repeated injuries, that’s when it becomes more than just a phase.

Not caused by “bad shoes” or “too much screen time”

There are a lot of myths out there. Hypermobility isn’t caused by:

• Going barefoot too often
• Sitting cross-legged or in W-sit
• Skipping stretching
• Spending too much time on screens

These things might highlight poor posture or coordination, but they don’t cause hypermobile joints. It’s all in the tissue structure — and that’s something we can work with, not reverse.

How podiatry can help – and what I do differently

By the time most families walk through our clinic doors, they’ve tried a bit of everything — physio, general advice, maybe even those squishy “flat feet” insoles from the chemist. But when it comes to hypermobility in kids, the key isn’t just cushioning the foot — it’s about improving control, strength, and stability from the ground up.

This is where podiatry really shines.

It starts with a detailed assessment

Every child I see gets a thorough lower limb assessment, not just a quick look at their arches. I watch how they walk, run, balance, and stand. I test their joint range and muscle strength. And I always take the time to listen — especially to the parent, who’s usually the one spotting those subtle day-to-day issues.

What I focus on in treatment

Here’s how we support hypermobile kids at Well Heeled Podiatry:

Strengthen what’s weak

Kids with hypermobility often have “lazy” stabiliser muscles — especially around the ankles, knees and hips. We introduce gentle, age-appropriate strengthening exercises that build support where it’s needed most.

Example: I had a 10-year-old footy player from Caulfield who kept rolling his right ankle. After just six weeks of targeted calf and peroneal strengthening, plus balance drills, his stability dramatically improved — and he hasn’t sprained since.

Balance and coordination drills

Proprioception (the body’s sense of joint position) is often reduced in hypermobile kids. We build it back with simple tools like wobble boards, hop drills, and barefoot balance activities.

A simple game like standing on one leg while brushing teeth is a game-changer.

Supportive footwear advice

The right shoes do a lot of the heavy lifting. I recommend shoes that:

• Have a firm heel counter
• Provide good midfoot support
• Are appropriate for school and sport

In Melbourne, that often means helping parents choose between rigid black school shoes and sportier options for PE days — it’s about function, not fashion.

Orthotics (custom, not generic)

I prescribe orthotics not to “fix” flat feet, but to:

• Improve alignment and gait efficiency
• Reduce fatigue and muscle overuse
• Prevent injuries during sport or play

We often fit slimline devices into school shoes and sports boots, and adjust them as your child grows.

Bracing and taping when needed

If a child is mid-season in netball, ballet or football, we may use ankle braces or taping short-term. These are great tools for reducing the risk of repeat sprains while we build strength behind the scenes.

Joint protection coaching

Kids with hypermobility sometimes overextend without realising it — knees locked backwards, elbows hyperextended. I teach them (and their parents) simple habits like:

• Keeping knees slightly bent when standing
• Avoiding sitting in W-position
• Resting without flopping into extreme positions

At-home care checklist for parents:

Support at home	Why it helps
Daily balance activity (e.g., 1-leg stance)	Builds ankle and core stability
Strength exercises (2–3 x/week)	Supports joints under load
Choose supportive shoes (no thongs/slippers)	Improves everyday alignment
Use orthotics if prescribed	Reduces pain and fatigue
Avoid over-stretching	Prevents further joint laxity
Educate, don’t overprotect	Builds confidence, not fear

Every plan I create is tailored — because no two kids with hypermobility are the same.

What to expect over time – hope and reassurance

The good news? Most children with hypermobility improve over time.

As kids grow, their soft tissues naturally stiffen up, muscles strengthen, and their nervous system matures — which means better control and less injury. That bendiness that was causing chaos in the early years? It often becomes much more manageable.

But — and this is important — the in-between stage can be tricky.

I often see kids around ages 8 to 13 who are “growing into their flexibility” but struggling with fatigue, sprains, or coordination problems. It’s a vulnerable time, especially as sport becomes more competitive and school demands increase.

Typical progress timeline in treatment

Here’s what I usually see when we begin treatment early:

Stage	What you’ll likely notice
Weeks 1–2	Immediate relief from pain with better shoes, bracing or orthotics. Kids often report “feeling steadier.”
Weeks 3–6	Muscle strength begins to improve. Night pain reduces. Trips and falls start to decline.
Weeks 6–12	Improved balance and coordination. Parents often say “They’re not clumsy anymore.” Sport becomes more fun.
3–6 months	Sustained improvement. Orthotics integrated into daily routine. Kids feel more confident moving, running, climbing.
6+ months	Regular reviews to adapt treatment. Most kids continue to build resilience and reduce dependence on supports.

Some children — especially those with connective tissue conditions — may need longer-term support. But with the right care, most kids build enough strength and control to enjoy sport, school and play without ongoing setbacks.

Long-term outlook

Hypermobility doesn’t mean your child will always struggle. With the right interventions:

• Their pain can be reduced or eliminated
• Injuries become far less frequent
• Their confidence in movement grows
• They’re able to fully participate in activities they love

One of my teenage patients now plays representative netball after struggling with knee pain from age 9. She still uses orthotics in her game-day shoes, but she’s strong, stable, and pain-free — and that’s what matters.